What question did this study set out to answer?

To identify modifiable clinical risk factors and provider behaviors associated with perioperative blood product transfusion in adult cardiac surgery.

August 20, 2026Anesthesia & Analgesia

The TIMELESS Project: A Mixed-Methods Analysis of Modifiable Risk Factors and Transfusion Practices in 24,000 Cardiac Surgical Cases

View Full Paper

Ask AI

Bookmark

Authors

ALAmmar M. LakdaCleveland Clinic JMJunhui MiCleveland Clinic XLXiaodan LiuWuhan Polytechnic University

Discussion

Member takes

Implication

Mixed-methods study identifies modifiable risk factors and empirical transfusion practices in cardiac surgical cases, suggesting avenues to reduce unnecessary transfusions.

Key Points

To identify modifiable clinical risk factors and provider behaviors associated with perioperative blood product transfusion in adult cardiac surgery.
Retrospective database analysis of adult cardiac surgery patients (N=24,005) from January 2018 to June 2024 to evaluate clinical risk factors across three perioperative domains.
Front-line provider survey administered to 258 anesthesia, surgical, and intensive care clinicians (112 respondents, 43% response rate) evaluating transfusion thresholds, triggers, and practice barriers.
Among 24,005 patients, 55.9% (n=13,420) received transfusions; risk-adjusted transfusion increased with preoperative anemia (IRR 1.74, 95% CI 1.67–1.83), perioperative hypothermia (IRR 1.66, 95% CI 1.59–1.73), malnutrition (IRR 1.44, 95% CI 1.36–1.54), and hyperglycemia (IRR 1.02 per 10 mg/dL, 95% CI 1.02–1.02).
Antifibrinolytic therapy was associated with decreased transfusion risk (IRR 0.90, 95% CI 0.86–0.93).
Empirical transfusions without laboratory guidance occurred in 32.1% of RBC, 44.9% of platelet, 55.0% of cryoprecipitate, and 82.4% of plasma administrations, driven by urgent bleeding (88%), prolonged surgical time (44%), and slow lab turnaround times (44%).

Cite This Study

Lakda et al. (2026) studied this question.

synapsesocial.com/papers/6a86b5eb8a91293e6a1cd8dd https://doi.org/10.1213/ane.0000000000008255

View Full Paper

Ask AI

Bookmark

Implication

Mixed-methods study identifies modifiable risk factors and empirical transfusion practices in cardiac surgical cases, suggesting avenues to reduce unnecessary transfusions.

The TIMELESS Project: A Mixed-Methods Analysis of Modifiable Risk Factors and Transfusion Practices in 24,000 Cardiac Surgical Cases

Discussion

Member takes

Implication

Key Points

Cite This Study

The TIMELESS Project: A Mixed-Methods Analysis of Modifiable Risk Factors and Transfusion Practices in 24,000 Cardiac Surgical Cases

Discussion

Member takes

Implication

Key Points

Cite This Study

Also Consider

Also Consider